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Please Note: The technology listed below is not available to the public at this time. This technology is in the early stage of research and requires further development before it is ready for the marketplace. The VA is currently in the process of identifying potential companies who may be interested in licensing and/or further developing the technology through Cooperative Research and Development Agreements (CRADA). Through cooperative research initiatives such as these, it is our hope and goal that commercial products will be fully developed and made available to benefit veterans and others.
VA TECHNOLOGY OPPORTUNITY BRIEF
Automated Constraint-Induced Therapy Extension (AutoCITE)
TECHNOLOGY BACKGROUND AND DESCRIPTION:
In the U.S., stroke is the primary cause of serious, long-term disability. Each year, of the almost 700,000 Americans who suffer a new or recurrent stroke, 15 to 30 percent remain permanently disabled. Moreover, 20 percent of stroke survivors still require institutional care 90 days post-stroke. This year alone, it is estimated that stroke-related medical costs could reach nearly $60 billion. The prevalence of stroke, coupled with its long-term physical, mental and economic devastation, underscore the need for successful rehabilitation for stroke victims.
For patients suffering from hemiplegic stroke (i.e., loss of motor function to one side of the body), numerous techniques exist for rehabilitation. Although conventional therapies have historically stressed compensatory training, i.e. learning to perform normal, everyday activities with the unaffected limb, more recent therapeutic approaches have focused on recovering motor activity of the affected limb through repetitive tasks, robotic trainers and drugs. One such "motor recovery therapy" gaining in popularity is Constraint-Induced Movement Therapy (CIMT).
CIMT was developed as a strategy for post-stroke arm rehabilitation. In CIMT, the unaffected arm is immobilized, thereby preventing its use. The affected arm is used repeatedly in a series of task-specific exercises, including grasping, reaching, pinching and tracing, focusing on shoulder, elbow, hand and wrist function. Despite demonstrating clinical efficacy and lasting benefits, CIMT requires substantial one-on-one therapist time, making it one of the most costly stroke rehabilitative therapies. In an attempt to reduce the costly therapist time of CIMT, automated constraint-induced therapy extension (AutoCITE) was developed.
AutoCITE employs easy-to-use software to guide the user through therapy exercises. Activities are the same as those employed in conventional CIMT. Sensors measure key aspects of the task and performance is automatically measured. Performance-based audible and visual feedback is provided to the patient. Efficacy of AutoCITE has been demonstrated clinically, where AutoCITE training with greatly reduced therapist supervision (25 percent) proved as effective in therapeutic outcome as standard one-on-one CIMT. Thus, a single physical therapist could now simultaneously monitor the rehabilitation of multiple patients. A home-based version of AutoCITE, employing a modified, down-sized version of the device previously utilized in the clinic is currently under development. In this form of tele-rehabilitation, a therapist could monitor and interact with the patient via video and sensor feedback to and from a central, facility-located work station. Through such modifications, it is hoped that CIMT will be made cost effective enough so as to become a standard form of stroke rehabilitation, making this highly beneficial therapy available to more patients.
BENEFITS
Potential to significantly improve stroke rehabilitation
- Proven effective in rehabilitating various populations of stroke victims including those afflicted with acute (one to two weeks after stroke) and subacute (i.e., three to nine months post injury) stroke
- Effective treatment for patients suffering from chronic hemiparesis (more than year post stroke)
- Shown by various imaging methods to be one of the few physiotherapies capable of inducing reorganizational changes in the cerebral cortex
- Provides enduring therapeutic benefits, lasting greater than one year post rehabilitation Results - Reduction in patient-care dollars and greatly enhanced quality of life Potential therapeutic efficacy against a variety of conditions affecting the central nervous system
- Demonstrated capable of producing major and sustained motoric function in patients afflicted with non-stroke-mediated hemiparesis
- Utility in the rehabilitation of patients afflicted with motoric dysfunction resulting from traumatic brain injury, cerebral palsy, multiple sclerosis and spinal cord injury (non-severed)
Results - Enhanced range of application
Market Opportunity
- Annually, 700,000 Americans suffer a new or recurrent stroke.
- More than two-thirds of stroke survivors will have some type of disability requiring rehabilitation to regain functionality and independence
- Stroke accounts for $37.3 billion in direct (hospital, nursing home, rehabilitation) costs and $20.6 billion in indirect (lost productivity, morbidity, mortality) costs
Results - Significant commercial potential
IP STATUS: A US non-provisional patent application was filed on June 19, 2006 (11/425,105).
FOR MORE INFORMATION CONTACT:
Saleem Sheredos
Program Manager
Technology Transfer Program
Veterans Affairs
Office of Research & Development (12TT)
5th Floor
103 South Gay Street
Baltimore, MD 21202
202-380-5080
Fax 410.962.2141
e-mail: saleem.sheredos@va.gov
Last Updated - January 18, 2007